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关键疾病相关的高血糖和新发糖尿病:一个回顾性队列研究
Navid Soltani1,2, Henrike Häbel3, David Nelson1,2
1Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
在ICU患者中,关键疾病相关高血糖症 (CIAH) 将在五年内发展新发糖尿病的风险增加一倍. 这一发现凸显了监测前没有糖尿病的重症患者的葡萄糖水平的重要性.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 糖尿病研究 糖尿病研究
背景情况:
- 高血糖在危急病患者中很常见.
- 关键疾病相关高血糖症 (CIAH) 对发生糖尿病的长期影响尚未完全理解.
- 识别ICU后糖尿病的危险因素对于患者的治疗结果至关重要.
研究的目的:
- 调查重症监护室 (ICU) 治疗期间的CIAH与随后新发糖尿病的发展之间的关联.
- 评估在ICU幸存者中发生糖尿病的风险,这些幸存者经历过高血糖症而没有先前存在的糖尿病或糖尿病前期.
主要方法:
- 追溯观察性研究涉及6633名ICU幸存者.
- 2010年至2021年间,从瑞典斯德哥尔摩的四个大学医院ICU收集的数据.
- 排除以前患有糖尿病或HbA1c≥6% (42 mmol/mol) 的患者;CIAH以胰岛素用于血糖控制 (6-10 mmol/L) 定义.
主要成果:
- 在ICU幸存者中,近一半 (46.7%) 患有CIAH.
- 糖尿病的5年累计发病率在患有CIAH (4.1%) 的患者中明显高于没有 (1.8%) 的患者.
- 多变量分析显示,CIAH与发生糖尿病的危险比率增加2.15倍有关.
结论:
- 在没有先前糖尿病或糖尿病前期的ICU患者中,关键疾病相关的高血糖症与出院后患糖尿病的风险增加有关.
- 这些发现强调了需要在ICU幸存者中保持警的葡萄糖管理和随访.
- CIAH可以作为未来糖尿病发展的早期指标.
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